Paving an Enrollment Superhighway: Bridging State Gaps Between 2014 and Today

The Affordable Care Act (ACA) provides a transformative vision for eligibility and enrollment in public and publicly subsidized health coverage: an enrollment superhighway that is streamlined, modern, seamless, integrated, easy for consumers to use, and connects Medicaid, CHIP and Exchange coverage. This vision contrasts sharply with most states’ welfare-era, paper-based systems that rely on complex eligibility rules and outdated technologies. This paper frames ACA’s vision and discusses gaps between 2014 and today and opportunities to close these gaps in four key areas: 1) Consumer Experience; 2) Eligibility and Enrollment Policy; 3) Technology and Systems Infrastructure; and 4) Governance and Administration.

Supported by the California HealthCare Foundation, based in Oakland, California.